Resp System and Posterior Mediastinum Flashcards

1
Q

Components of the Respiratory System

A

Nasal cavity, nasopharynx, larynx, trachea, bronchi, bronchioles, lungs

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2
Q

Carina

A

Bump/ring where the trachea divides to form the bronchi.

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3
Q

Differences between the Right and Left Bronchi

A

RIGHT: Shorter, more vertical, larger diameter (because right lung is larger)

LEFT: Longer (further to travel), more horizontal (arch of the aorta goes over the left main bronchus), smaller diameter (left lung is smaller to accommodate the heart).

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4
Q

Eparterial bronchus

A

Goes to superior lobe on the right side and is branch of the right bronchus. OFTEN TAGGED

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5
Q

Branching of the right bronchus

A

Branches into the:

  • eparterial bronchus (branch to the upper lobe)
  • bronchus intermedius aka hyparterial (branch to the middle/lower lobes)
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6
Q

Basic anatomical features of the lungs

A

Both lungs have an apex, base, root and hilum

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7
Q

What is the hilum of the lungs? What are the roots?

A

These terms are often interchangeable.

HILUM- structures that come and go from the lungs (pulmonary veins/arteries, bronchial vessels, nerves, lymphatics etc.)

ROOT- the lung tissue where these structures enter in

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8
Q

The parietal and visceral layers of the pleura are continuous where?

A

The Root

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9
Q

Distinct characteristics of the Left Lung

A
  • 2 lobes (superior and inferior– divided by the oblique fissure)
  • Lingula (tongue like extension of the superior lobe)
  • The pulmonary artery is above (superior to) the bronchus
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10
Q

What divides the superior and inferior lobes of the left lung?

A

-The oblique fissure

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11
Q

Pulmonary ligament

A

A fold at the root of the lung which is composed of a double layer of parietal pleura which is extending towards the hilum.

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12
Q

Most vessels are Posterior or Anterior to the Bronchus?

A

Anterior

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13
Q

Pulmonary trunk/arteries are Inferior or Superior to the pulmonary veins?

A

Superior. The veins are mostly in back of the heart, on the posterior side.

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14
Q

Distinct characteristics of the Right Lung

A
  • 3 lobes (superior, middle and inferior)
  • 2 fissures (oblique, horizontal)
  • The pulmonary artery is NOT superior to the bronchus– they are at the same level, because the eparterial bronchus branches high.
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15
Q

Oblique fissure

A

Divides the superior from inferior (posteriorly)

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16
Q

Horizontal fissure

A

Separates the superior from the middle

17
Q

Projection of lungs anteriorly

A
  • Apex of lung extends into the roof of the neck anteriorly
  • Medially, both come close to the sternum
  • Cardiac notch on left side to accommodate the heart (4th rib)
  • Oblique fissures intersect around 6th rib anteriorly and the 2nd rib posteriorly (towards the midline)
  • Horizontal fissure intersects 4th rib (towards the midline)
18
Q

Describe the vascularization of the lungs

A
  • Pulmonary and Bronchial vessels (bronchial arteries contain oxygenated blood. Pulmonary arteries do not)
  • During systole, the blood in the right ventricle enters the pulmonary trunk
  • Bronchial arterial branches move in association with the bronchi
  • Pulmonary veins run in the fascia between bronchopulmonary segments
19
Q

Anthracotic structures

A

Dark particulate matter found in adult lymph nodes near the lungs

20
Q

The two types of lymph nodes in the lungs

A
  • Bronchopulmonary (root of the lung)

- Tracheobronchial (tracheal termination and two main stem bronchi)

21
Q

Innervation of the Lungs

A

Both parasympathetic (CN X) and sympathetic supply. Both are from plexuses which are along the great vessels of the heart.

22
Q

Basics of adult respiration

A
  • Normal respiration is diaphragmatic
  • Ribs are raised when more oxygen is needed
  • Anterior (upper) thoracic wall moves anteriorly
  • Lower (lateral) thoracic wall moves laterally
  • Accessory muscles (mostly serratus anterior) can help increase thoracic wall size
23
Q

Extension of the parietal layer surface area does what?

A

Increases the surface area of the visceral layer because it is a closed space, so the lungs expand.

24
Q

Surfaces of the Parietal Pleura

A

Costal: associated with ribs
Mediastinal
Diaphragmatic
Cupola: Parietal part of lung which extends into the neck to cover the apex of lung (suspended by Sibson’s fascia which holds it in place so it isn’t sucked back into the thorax)

25
Q

How far does the parietal pleura extend? The diaphragm?

A
  • Parietal (T12)

- Diaphragm (L2)

26
Q

Define a pleural recess. What are the two most important ones?

A

Pleural recesses are spaces formed between the parietal and visceral pleura, allowing for maximum expansion of the lungs during forced inhalation.

Two main ones:

  • costodiaphragmatic recess(lowest one and most important)
  • costomediastinal recess
27
Q

The two most important lines when projecting the lungs onto the body surface

A
  • Midclavicular

- Midaxillary (lateral view)

28
Q

The parietal pleural projections

A
  • (2) Cupola meets midline at second rib
  • (4) Cardiac deviation of left lung is at the fourth rib
  • (6) Deviation of the right lung
  • (8) The parietal pleura intersects at the mid-clavicular line at the eighth rib
  • (10) The parietal pleura intersects at the mid-axillary line at the tenth rib
  • (12) The parietal pleura intersects posteriorly at the twelfth rib
29
Q

Difference between where the parietal pleura project on chest wall and where the visceral pleura/lungs project.

A

There is a 2 rib difference (visceral hits mid-clavicular, mid-axillary and the posterior two ribs earlier)

30
Q

What does the Posterior Mediastinum contain?

A

a. aorta
b. esophagus
c. vagus n.
d. azygos and hemiazygos v.
e. thoracic duct
f. sympathetic chain

31
Q

3 main structures which pass through the diaphragm.

A

(1) Inferior Vena Cava- T8
(2) Esophagus- T10
(3) Aorta- T12

I ate 10 Eggs At Noon

32
Q

Main channel which accepts blood from the posterior intercostal veins.

A

Azygus. It tends to be on the right side. It then drains into the superior vena cava.

33
Q

Which splanchnic is often tagged?

A

Greater

34
Q

Which Bronchi will you first look for aspirated foreign bodies?

A

Right main Bronchus. It is larger in diameter and more vertical.

35
Q

Trachea divides at which intercostal space?

A

The second (above the third rib)